[Acute pancreatitis. Functional morphology of a peculiar disease (author's transl)].

The pathogenetic factor of acute pancreatitis is the autodigestion of the pancreas. Autodigestion takes place on the effect and dependent from the complete pancreatic juice, not only from one single or several enzymes. In the same way, the clearance of the necrosis can be deduced from the enzymatic activity (formation of pseudocysts). Autodigestion can only take place after the breakdown of protective mechanism, the cell metabolism play a decisive rôle. The edema of pancreatic juice as a consequence of the flow of pancreatic juice being hindered must be seen as the inversion of the physiological juice secretion across the intercalated ducts. It represents a (limited) protective mechanism against the accumulation of pancreatic juice. In the clinical course there can be observed an augmentation of amylase in blood. This augmentation of amylase concentration in blood is not identical with pancreatitis.